The primary aim of this proposal is to improve end-off-life (EEL) care for patients in cancer centers. In 2000, about 552.200 Americans are expected to die of cancer (1 in every 4 deaths). While national initiatives are providing evidence of the support patients and families need to deal with symptoms, decisions and burdens of dying, dissemination through professional education is minimal. The primary aim will be achieved through 4 annual workshops for 2 representatives each from 75 cancer treatment centers (600 total participants). The project builds on the investigators' previous experience with similar national workshops on pain management, palliative care education for home care staff, and a nursing EOL curriculum being developed with the American Association of Colleges of Nursing and supported by the Robert Wood Johnson Foundation. Specific aims to be accomplished are to: (1) Adapt the existing EOL curriculum to focus on patients with cancer and address an interdisciplinary professional audience in cancer centers. (Nurses, social workers and physicians in tier 1, and clergy, pharmacists, psychologists, rehabilitation professionals and unlicensed personnel in tier 2). (2) Implement the curriculum in national workshops to competitively selected staff from NCI-designated cancer centers, and members of the Association of Community Cancer Centers. (Two people from each institute with at least one from tier 1), (3) Develop a Community Cancer Center. participants-network to share experiences in dissemination, (4) Evaluate the impact of the curriculum on participants' and cancer center staffs' knowledge and attitudes about EOL care and the implementation of individual goals for improved EOL care, (5) Evaluate EOL care at 3 levels - the participant, the interdisciplinary cancer team, and the institution level - for the ability to change and sustain improvements in EOL care, (6) Describe successes and issues related to dissemination in terms of the characteristics of individual participants, interdisciplinary teams, and institutions, and (7) Refine the curriculum for broad dissemination to cancer centers to improve EOL care for cancer patients nationwide.